An investigation of completion times on the Screener and Opioid Assessment for Patients with Pain – revised (SOAPP-R)

Abstract

BackgroundRespondents’ scores to the Screener and Opioid Assessment for Patients with Pain – revised (SOAPP-R) have been shown to be predictive of aberrant drug-related behavior (ADB). However, research is lacking on whether an individual’s completion time (the amount of time that he/she takes to finish the screener) has utility in predicting ADB, despite the fact that response speed has been useful in predicting behavior in other fields. The purpose of this study was to evaluate the degree to which SOAPP-R completion time is predictive of ADB.Materials and methodsThis retrospective study analyzed completion-time data from 82 adult emergency department patients who completed the SOAPP-R on a tablet computer. The utility of SOAPP-R completion times in predicting ADB was assessed via logistic regression and the area under the curve (AUC) statistic. An external measure of ADB using Prescription Drug Monitoring Program data defined ADB to have occurred in individuals with at least four opioid prescriptions and at least four prescribers in 12 months.ResultsAlthough there was a slight trend for individuals with greater completion times to have greater odds of ADB (odds ratio 1.004 in simple logistic regression), the association between SOAPP-R completion time and ADB was not statistically significant in either simple logistic regression (P=0.307) or multiple logistic regression adjusting for SOAPP-R score (P=0.419). AUC values for the prediction of ADB using completion time alone, SOAPP-R score alone, and both completion time and SOAPP-R score were 0.63, 0.64, and 0.65, respectively.ConclusionThere was no significant evidence that SOAPP-R completion times were predictive of ADB among emergency department patients. However, the AUC value for completion times was only slightly less than that for SOAPP-R total scores.

Prospective, Longitudinal Study to Evaluate the Clinical Utility of a Predictive Algorithm to Detect Opioid Use Disorder in Chronic Pain Patients

“…This is in contrast with published studies describing the specificity of the SOAPP ® -R 52%, [35] and the sensitivities of the SOAPP ranging from 72% to 80% [35,36] and the ORT 45% [36]. The published AUC of the SOAPP-R ranges from 0.67-0.76, [37] which are lower than the AUC of the profile, in all cases except one. Analyzing rating patterns sheds light on how physicians use and appreciate the profile.…”

<p>Increased frequency of urine drug testing in chronic opioid therapy: rationale for strategies for enhancing patient adherence and safety</p>

“…While many advocate for the utilization of opioid risk screening tools among patients at risk for aberrant behavior, these tools lack validity scales to ensure (or at least predict) the veracity of the responses. Furthermore, the intended purposes of these instruments are fairly transparent, and higher risk patients responding in a manner suggesting lower-than-actual risk has been documented 28. Although early studies of the COMM15,16,29 substantiated the validity of the measure through significant relationships with UDT results, both the current study and another 2019 investigation30 of HIV-positive patients taking opioids did not find a significant relationship.…”

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“…43,44 Chronic pain can lead to longterm opioid use in a subset of patients and can lead further to misuse and addiction. 43,44 The most common and simplest survey instruments for screening include the Screener and Opioid Assessment for Patients with Pain-revised, a 5-question tool, 45,46 and the Current Opioid Misuse Measure, a 17question scale. 47 Both measures can identify at-risk patients quickly, so appropriate referral or development of an opioid contract linked to monitoring and non-opioid treatment strategies can be implemented.…”